Finger Robert P, Sivasubramaniam Selvaraj, Morjaria Priya, Bansal A, Muhit Mohammed, Kinra Sanjay, Gilbert Clare E
Department of Ophthalmology, University of Bonn, Bonn, Germany Centre for Eye Research Australia, University of Melbourne, Melbourne, Australia.
Department of Clinical Research, International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK.
Br J Ophthalmol. 2015 Jun;99(6):762-7. doi: 10.1136/bjophthalmol-2014-305971. Epub 2015 Jan 6.
Lens opacities (LO) occur at an earlier age and have a higher prevalence in developing countries. In this pilot study, we assessed the feasibility and practical challenges of conducting a migration study, testing the hypothesis that migration from Bangladesh to the UK decreases the amount of LO on account of less exposure to adverse environmental factors.
The sample, which was selected from East London, UK and in Bangladesh, underwent detailed examination and lens grading by the same certified grader using Lens Opacification Classification System III. Data were analysed using univariate and multivariable logistic regression analyses.
Considerable difficulties were encountered in recruiting the sample in both locations. 372 Bangladeshis aged 40-70 years were examined: 131 in London and 241 in Bangladesh. Having never migrated from Bangladesh was an independent risk factor for opacities (OR 7.6; 95% CI 3.6 to 15.9; p=0.001) as were age (OR 7.1; 95% CI 4.0 to 12.7; p=0.001) and diabetes (OR 2.5; 95% 1.0 to 6.0; p=0.04). The odds of LO were lower among those who had lived in the UK for a higher proportion of their life (OR 0.96; 95% CI 0.93 to 0.99; p=0.01), but this was not significant after adjusting for age and diabetes (OR 0.97; 95% CI 0.94 to 1.01; p=0.16).
The study highlights the challenges of migration studies, and of studies involving ethnic minorities. Preliminary findings suggest that migration to the UK is protective for LO despite a significantly higher rate of diabetes in the UK. A larger study is warranted based on these preliminary findings.
晶状体混浊(LO)在发展中国家出现的年龄更早,患病率更高。在这项试点研究中,我们评估了开展一项移民研究的可行性和实际挑战,检验了从孟加拉国移民到英国会因较少接触不利环境因素而减少晶状体混浊数量这一假设。
从英国东伦敦和孟加拉国选取样本,由同一名经过认证的分级人员使用晶状体混浊分类系统III进行详细检查和晶状体分级。数据采用单变量和多变量逻辑回归分析。
在两个地点招募样本时都遇到了相当大的困难。对372名年龄在40 - 70岁的孟加拉人进行了检查:131人在伦敦,241人在孟加拉国。从未从孟加拉国移民是晶状体混浊的一个独立危险因素(比值比7.6;95%置信区间3.6至15.9;p = 0.001),年龄(比值比7.1;95%置信区间4.0至12.7;p = 0.001)和糖尿病(比值比2.5;95% 1.0至6.0;p = 0.04)也是如此。在一生中在英国生活比例较高的人群中,晶状体混浊的几率较低(比值比0.96;95%置信区间0.93至0.99;p = 0.01),但在调整年龄和糖尿病因素后这并不显著(比值比0.97;95%置信区间0.94至1.01;p = 0.16)。
该研究突出了移民研究以及涉及少数民族的研究的挑战。初步研究结果表明,尽管英国糖尿病发病率显著更高,但移民到英国对晶状体混浊有保护作用。基于这些初步研究结果,有必要开展更大规模的研究。